Zaburzenia napadów w dorosłych: Zrozumienie typów epilepsji i zdarzeń nienienaileptycznych
Seizure Disorders in Adults: Understanding the Types of Epilepsy and Nonepileptic Events
W skrócie
Artykuł dotyczy problemów z niższymi partiami dróg moczowych u mężczyzn, które mogą być spowodowane powiększeniem prostaty, nadreaktywnym pęcherzem moczowym lub kombinacją obu stanów. W diagnostyce i leczeniu stosuje się kwestionariusze, leki (blokery alfa-1, inhibitory 5-alfa reduktazy) i zabiegi chirurgiczne, a pierwszą linię leczenia stanowią agoniści beta-3 oraz terapia i ćwiczenia mięśni dna miednicy. Nieleczone zaburzenia mogą prowadzić do społecznej izolacji i problemów w relacjach.
Oryginalny abstract (angielski)
Lower urinary tract symptoms that significantly impair quality of life in men may result from benign prostatic hyperplasia, overactive bladder, or a combination of both conditions. The diagnosis of benign prostatic hyperplasia, a voiding dysfunction due to outlet obstruction, can be made with a thorough history and physical examination. A validated questionnaire should be used to make an accurate initial diagnosis and to monitor treatment effect over time. Selective alpha-1 blockers are an appropriate first-line drug choice for most patients; however, 5-alpha reductase inhibitors and phosphodiesterase type 5 inhibitors may also be used, alone or in combination with each other, depending on symptom severity and if alternative treatment options are needed. If medical therapy is ineffective, surgical and interventional procedures aimed at opening the prostatic urethra are available to ameliorate symptoms. Overactive bladder manifests with urinary urgency, frequency, and nocturia with or without incontinence. The diagnosis of this storage dysfunction due to detrusor overactivity can be made with a thorough history, physical examination, urinalysis, and assessment of the residual volume of urine in the bladder after voiding. First-line treatment for overactive bladder includes beta-3 agonists as well as pelvic floor physical therapy and behavioral interventions. If left untreated, benign prostatic hyperplasia and overactive bladder can result in significant social isolation and relationship strain.